Surgical treatment: Since Lewsl pioneered the first surgical resection of craniopharyngioma in the world in 910, the surgical results have been greatly improved. However, because of its close relationship with the hypothalamus and often adherence to the pituitary stalk, funnel and medial bulge, total surgical resection of the tumor is difficult and partial resection has poor long-term results. 17 of 48 cases of craniopharyngioma in children reported by Hoffman (1982) were completely resected, with a total resection rate of 35.4%; 16 cases were aspirated with cystic fluid, and the other 15 cases were subtotal resection. The total mortality rate (including deaths from surgery and follow-up) was found to be 11.8%, 13.3% and 62.4% in the total resection group, secondary resection group and cystic fluid aspiration group, respectively. Yasargil (1990) reviewed 144 cases of craniopharyngioma resected by microsurgical techniques, with a 90% complete tumor resection rate, 67.4% good results, 16% disability rate, and 16.7% overall mortality. duff et al. (2000) reported 121 cases of craniopharyngioma, with a 57% complete surgical resection rate, 43% near-total resection rate, and 1.7% surgical mortality. Fahlbusch et al. (1999) reported 168 cases of craniopharyngioma, with a total resection rate of 49.3%, a near-total resection rate of 22.3%, and a partial resection rate of 21%, and an operative mortality rate of 0 for the transsphenoidal approach, 1.1% for the initial operation and 10.5% for the recurrent operation. The most common reason why the tumor cannot be completely resected is because of the serious adhesion between the tumor and hypothalamus, in order to avoid damaging the hypothalamus, the operator can only give up the complete resection and leave the tumor. The operative mortality rate was about 30% in the early years, but in the past 10 years, the statistical results of large number of cases were 0-16.7%. The mortality rate of surgery is related to many factors: for example, the mortality rate is higher for huge tumors, tumors invading the third ventricle and compressing the hypothalamus and severe endocrine hypofunction before surgery; the mortality rate is also higher for total resection or subtotal resection of tumors because of more serious damage to the hypothalamus; radiotherapy: the evaluation of the effect of postoperative radiotherapy for craniopharyngioma was more controversial in early years, on the one hand, it is believed that craniopharyngioma is well differentiated and most of them are cystic lesions. On the one hand, it is believed that craniopharyngioma is well differentiated and mostly cystic lesions, so radiotherapy rarely has a therapeutic effect; however, it is also believed that craniopharyngioma originates from squamous epithelial cells and should have a certain sensitivity to radiation. Most authors now believe that radiotherapy for craniopharyngioma has a role in prolonging patient survival and delaying recurrence, and that radiotherapy for craniopharyngioma in children is more effective than that for adults. In recent years, with the development of computer technology and the clinical application of CT, MRI and other diagnostic imaging devices, the size, shape, volume and location of craniopharyngioma can be accurately determined, and the further development of the software system for directional surgery has made it possible to provide radiotherapy for cystic craniopharyngioma. The dose, time and speed of interstitial radiotherapy can also be accurately calculated, and intracapsular radiotherapy has now become the first choice for the treatment of cystic craniopharyngioma. For cystic, thick-walled, and partially substantial craniopharyngiomas, multiple intracranial radiotherapy sessions are feasible, and the larger parenchymal portion can be combined with gamma knife. Most craniopharyngiomas are cystic or cystic solid, and the clinical manifestations of cystic craniopharyngiomas are mainly caused by the compression of the adjacent cysts. The clinical manifestations of cystic craniopharyngioma are mainly caused by cystic compression of the adjacent tubes and nerves. The key to the treatment of cystic cystic pharyngioma is to release the cyst compression. After the cystic fluid is extracted by puncture, the volume of the tumor can be reduced immediately to relieve its compression symptoms. On this basis, radioisotope is injected into the cyst to effectively kill the endothelial @cell of the tumor and destroy its secretion function, so that the cyst wall can gradually shrink. At the same time with the parenchymal part of the tumor auxiliary with gamma knife treatment, so that the parenchymal component of the tumor cells die, delaying the recurrence of the tumor, and even Sterculia street good offices Kangmo lemon quality excel plague quite leaning on the month to make the alligator-related shape (3) choking bath Aman strokes. The tumor is not suitable for craniotomy. If the patient is not suitable for craniotomy, he can be treated with multiple times of intraperitoneal radiotherapy within a short period of time, and the effect is satisfactory, and the long-term control rate of tumor reaches 79.5%-88%, which brings new hope for the treatment of craniopharyngioma. The main advantage of using intracranial radiation therapy is that it can enhance the local treatment effect of the tumor and reduce the radiation damage to the surrounding brain tissue at the same time. The radioactive source used is chromium phosphate suspension containing 32 phosphorus. For cystic or cystic solid tumors, it can be injected directly into the tumor cavity or after external drainage and waiting for the cavity to collapse, and for solid tumors, it can be implanted into the tumor tissue as a needle carrier. Interstitial radiotherapy requires isotope preparation to be chemically stable, easy to disinfect and non-toxic, and should have the following conditions: ① produce pure β-rays; ② cannot penetrate the tumor wall and diffuse into the surrounding tissues and blood; ② uniform distribution in the tumor; ④ radioactive half-life should not be too long, generally not more than two weeks. At present, under the guidance of CT or MRI, stereotactic technique is used to inject radionuclides directly into the cystic cavity of craniopharyngioma with precise positioning, which not only can avoid important nerves or blood vessels in the cranium and directly puncture the tumor with an accuracy within 1.5mm, but also can accurately calculate the tumor volume and the reasonable amount of radionuclides. The requirement for the operation is to minimize the damage to the capsule wall and avoid spillage when injecting the isotope into the tumor capsule. If the puncture needle passes through the lateral ventricle, it is better not to puncture directly at the exposed part of the tumor at the interventricular foramen, but to puncture into the tumor cystic cavity through the hyaline septum or the lower wall of the ventricle slightly in front of the interventricular foramen, because most of the tumor cystic walls protruding into the third ventricle are very thin and easily broken, and the needle hole is difficult to close by itself after puncture. 32P is pure β-radiation, with an intra-tissue penetration of 4mm, low radiation rate (0.4~0.6Gy/h) and long irradiation time (half-life of 14.3d). The long half-life has the biological advantage of continuous irradiation of the whole tumor cell cycle, and the gradually accumulated therapeutic radiation dose can reach 200-400 Gy. The colloidal chromium phosphate injected into the tumor cavity can evenly distribute in the tumor cavity wall, releasing 90% of the pure beta-ray energy. It is an ideal isotope for intratumoral radiotherapy because 90% of the pure beta-radiation energy released is concentrated in the tumor cells of the cyst wall, which can effectively kill tumor cells, but the killing effect of the beta-radiation released is limited to tumor cells at a distance outside the cyst wall because the maximum distance of penetration and killing in the tissue is 7.9 mm. Kobayashi et al. applied a modified internal irradiation dose formula to accurately calculate the irradiation dose at any point of the source and on the tumor wall, and concluded that 100-300 GY is the optimal internal irradiation dose, pointing out that early tumor recurrence often occurs when the dose of nuclide injected into the cystic cavity of craniopharyngioma is less than 100 Gy (10,000 rad), so the dose should be large enough. At present, the volume of injected isotope and radiation dose are mostly determined by the size of tumor cavity. Generally, the dose of radioactive colloidal chromium phosphate injected into the cavity is calculated according to the formula of mCi (injected radiation dose) = 27.4V/f based on the size of the cavity. This is especially important when the volume of the tumor capsule is small, because aspiration of the capsule fluid can achieve immediate decompression, and if the volume of injected isotope is too large, the purpose of decompression cannot be achieved, and it is also not conducive to the coating of internal radiotherapy drugs on the tumor capsule wall. When Berge et al. treated cystic craniopharyngioma with yttrium-90 intracapsular radiotherapy, they found that the visual acuity of some patients deteriorated compared with the previous one. Stereotactic isotope intrastromal radiotherapy for cystic tumors has a history of nearly 50 years and is considered to be efficacious, especially for postoperative recurrence. However, a large number of case studies have shown that about 17.5% of patients do not have satisfactory results with this therapy, and about two-thirds of patients need to receive multiple intracapsular radiations, but there are also patients who are very sensitive to this therapy, indicating that there are significant differences in the efficacy of the same therapy for different patients. The current study found that the main factor affecting the treatment effect is the tumor volume, the larger the volume, the more 32P is needed to reach 200Gy of radiation dose to the capsule wall, and to prevent complications caused by excessive use of radioisotope and have to reduce its dosage, making the number of treatments increase and the efficacy is poor. More importantly, 32P is colloidal and has poor mobility. After the small volume of the bursa is injected, all parts of the bursa wall can contact the colloidal isotope evenly, and the whole bursa wall can be irradiated effectively; however, for the bursa with huge volume, the bursa wall is prone to folding after the bursa fluid is pumped out, and it is difficult for the isotope to flow, so only a small part of the bursa wall may be in contact with the isotope, and the therapeutic effect is reduced. 2.Intra-stromal chemotherapy: Some scholars also reported that the injection of chemotherapy drugs into the cystic craniopharyngioma has achieved significant therapeutic effect. Cavalheiro et al. treated a huge cystic craniopharyngioma with repeated injection of bleomycin into the cavity through Omaya tube. 3.External irradiation therapy: External irradiation is a widely used radiotherapy method because of its easy dose control and low radiotherapy contamination. Postoperative radiotherapy for craniopharyngioma to prolong the survival and recurrence interval has been accepted by most authors. The scope of radiotherapy is generally localized, with a dose of 55 Gy (5500 rad) in the tumor bed after partial resection of the tumor, to be completed within 6 weeks (5 times per week, total 30 times/42 days). It is generally believed that radiotherapy doses of less than 200 rad per day in children can reduce the occurrence of radiotherapy complications. It is still controversial whether radiotherapy should be given to patients who have undergone total tumor resection. Most people believe that even if total tumor resection is performed, tumor remains in the postoperative CT follow-up. Therefore, postoperative radiotherapy is necessary even for those who have undergone total tumor resection. However, some scholars advocate that postoperative CT examination should be performed first for total resection of tumor and radiotherapy should be performed when tumor residue is confirmed, otherwise, only CT follow-up should be performed. Prognosis of craniopharyngioma: There is a certain recurrence rate after total resection of craniopharyngioma, up to 50% in early stage. Yasargil (1990) and others followed patients for up to 22 years and only 7% of total resected patients recurred. samii et al. (1991) followed 34 total resected patients for up to 10 years and only one recurrence was observed. Fahlbusch (1996) reported a recurrence rate of 5% in the total resection group, 25% in the subtotal resection group, and 38% in the partial resection group. The first-year recurrence rate was 6.0% in the total resection group, which was significantly lower than that in the near-total resection group (22%), and postoperative radiotherapy also significantly reduced the postoperative recurrence rate. The longest survival after surgery for craniopharyngioma in children was reported by Cushin in 1932 in an 11-year-old boy, who survived for 50 years after surgery. The 10-year survival rate after surgery for 168 craniopharyngioma cases was 92.7% in the total resection group and 87% in the near total resection group.